الفهرس 
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Abstract
Introduction: Atherosclerotic vascular disease, the first killer on earth, has become a dreadful epidemic in the present century. It starts insidiously and progresses silently. It starts essentially as endothelial dysfunction. The endothelium is the source of the bioactive substances responsible for the vitality, health of the vessel wall and govern the tone, degree of vessel dilatation and blood pressure. Low level laser (LLL) is known to photobiostimulate the release of the vasoactive hormones of the endothelium. Aim of the Work: To evaluate the use of LLL to stimulate endothelial mediated dilatation in the different risk categories of patients on the way to establish the cut off segregating values, to detect early endothelial dysfunction. Patients and Methods: The 50 type 2 diabetic females studied revealed three risk groups (1), (2), (3), after their categorization according to the Framingham cardiovascular risk scoring. The brachial artery diameter of these patients was measured ultrasonographically before and after direct application of LLL to the artery. The same was done to 40 of them after sham laser application (as control). Nitric oxide (NO) was measured before and after LLL application and the same was done to 30 of the 40 sham cases (as control). Results: There was increase in serum NO after LLL P < 0.005 but not after sham laser P < 0.41. Again, there was a significant number of patients whose artery diameter increased after LLL P < 0.0005 than after sham laser P < 0.032. Again, the increase in the arterial diameter was more in the less risk group than in higher risk group. i.e. the healthier the artery the more the dilatation. The mean percent (%) dilatation of the brachial artery in the three Framingham groups 1, 2, 3 was 7.27, 6.47 and 6.41 respectively, P < 0.84. Conclusion: Low level laser is effective in dilating the brachial artery; and the dilatation was more the lower the risk status. Key words: endothelial dysfunction, type 2 diabetes, laser.